WORLD Malaria Day: Eradicating man’s worst enemy, the mosquito

Over the centuries, mosquito bite has been the major cause of malaria. Recently, zika fever has been
associated with mosquito bite. Owing to this huge health burden caused by mosquitoes, nations
join forces to fight and accelerate the eradication of this man’s common enemy, writes JOYCE REMI-BABAYEJU

Today, the world marks this year’s World Malaria Day and the activities lined up for the celebration indicates another milestone in a global effort towards eradicating mosquitoes and malaria, the common enemy of man. Mosquitoes have caused the deaths of over one million people around the world. There is no over stating the fact that malaria has dealt a hard blow on mankind in the form of out of-pocket spending, man lost hours, effect on families and development. According to WHO reports in 1900, malaria was endemic in almost every country in the world and throughout the first halve of the 20th century, it killed about 2 million people yearly. Mosquitoes have kill not less than one million people yearly, but now the World Health Organisation, WHO, statistics shows that the number of caseloads are beginning to dwindle globally because in hitherto countries with high burdens have successfully eradicated the fever from their lands. In Nigeria, malaria still accountsfor almost half of hospital visits to primary, secondary and tertiary health facilities. The worst hit are pregnant women and children under age five. The Nigerian National Malaria Strategic Plan 2014-2020, report shows that malaria is responsible for 60 percent of outpatient visits to health facilities, 30 percent of childhood deaths, 25 percent of deaths in children under one year, and 11 percent of maternal deaths,” he said.
With these figures, Nigeria still has the highest burden of malaria in sub-Saharan Africa and even the world due to ignorance and lack of proper procedures in controlling the mosquito spread in neighbourhoods. Ahead of this year’s celebration in Nigeria, the United States Ambassador to Nigeria, Mr James Entwistle, said that with about 300,000 deaths out of 100 million cases of Malaria, Nigeria has the highest number of malaria causalities globally, largely due to the widespread of fake and substandard medicines in the country.
Entwistle noted that despite so many gains in malaria prevention and treatment, the widespread prevalence of counterfeit, substandard medicines is contributing to the alarmingly high number of malaria deaths and costs of health care in Nigeria.
As Nigeria marks the 2016 World Malaria Day with the theme “End Malaria for Good” with a slogan, “Yes it is achievable’’, the National Coordinator National Malaria Elimination Programme, NMEP, Dr. Nnenna Ezeigwe, in an exclusive interview with Nigerian Pilot in
Abuja debunked the belief that malaria is still a high burden in Nigeria.
She said that it is not true that most people who have fever have malaria. “I want to correct the impression about malaria”, she said.
“When people have fever and they go to the hospitals, the first thing that comes to their minds is that it is malaria, but I want to say that all is not malaria because other things
can cause fever. There are viral infections, common cold, Ebola, Lassa fever and all these can cause fever.
“The ones that are confirmed to be malaria is through tests and are not as many in Nigeria of today. We are raising awareness for people to get tested before treatment in line with the malaria policy and when they do test positive, we are also raising awareness about how to be treated with the correct medicine which is the Artesimin Based Combination therapy, ACT”, he said.
According to Ezeigwe, when people are sick with fever and they visit hospitals, they should do malaria test by Rapid Diagnostic Test, RDT, which is not expensive as microscopy test. She advised that people including pregnant women and children should access the RDTs
for free at most Primary Health Care facilities supported by Global Fund.
“In these facilities, especially in the 24 high burden states where malaria is high we have made available the Rapid Diagnostic Tests and the ACTs so you get tested for free and treated for free’’, she explained.
The 24 Global Fund supports states including Akwa Ibom, Anambra, Bauchi, Benue, Cross River, Edo, Ekiti, Imo, Jigawa, Kaduna, Kano, Katsina, Kebbi, Kogi, Kwara, Lagos, Niger, Ogun, Ondo, Osun, Oyo, Rivers, Sokoto and Zamfara.
The NMEP coordinator said that Nigeria is fastening its process of ending malaria through training to empower patent medicine sellers to be able to test people using RDTs and sell ACTs correctly because a lot of people just walk into chemists and ask to buy but ACTs without testing, so we are able to empower them to do the tests and to sell the medicines now to people.
Eziegwu assured that the ACTs with the green leaf logo which is supported by the Global Fund are available at patent medicines stores at subsidized rate not costing more than N200. But bringing malaria to its heels has not just required money but also imagination,
persistence and political will because elimination would save millions of lives and trillions of
dollars in lost productivity and health costs, mostly in low income
economies like Nigeria.
According to her, controlling malaria in the country depends on budgetary allocation and help
from partners because Global Fund has contribute a lot in the fight against malaria but in the 10 years over 1 billion dollars cumulative of government and all partners have been spent on the chase of malariain Nigeria.
The Bill and Melinda Gates Foundation, a fervent source of funds for anti-malarial research and control efforts believes that malaria can be eradicated completely by 2040. “Yes it is possible to eliminate malaria from Nigeria because it has actually been eradicated in some
countries so why can’t it happen in Nigeria?” Ezeigwe concorded.
According to Ezeigwe, “This is because we know the cause of malaria; it is caused by
plasmodium parasite and it gets from one person to the other when the female anopheles mosquito takes it from one person and takes it to another person. We also know
that mosquitoes breeds in bodies of water, in unhygienic environments, and we also know that if one comes down with malaria, that there is treatment that is capable of curing.
If we know all these things, then why can’t we eliminate malaria?”
she asked.
Also you can remove the reservoir where mosquitoes can breed and if you can make your
environment clean, sleep under a mosquito net so mosquito would not touch you then if it
bits someone with malaria it cannot touch you because you are running away from it. But
unlike in countries where this feat has happened, in Nigeria, the challenge is that people
don’t believe that malaria can be eliminated from Nigeria, Ezeigwu observed. ‘’Nigerians
are sceptical of the fact that malaria can be eliminated here and because of this they are not
prompted to do what they ought to do.
‘’We make people to know that we have commodities in facilities and also available. They should go to hospitals and access these drugs. They should keep their environments clean and sleep under mosquito treatment nets.
By registering for ante-natal when women are pregnant and in hospitals, they should
ask their healthcare providers for Intermittent Preventive Treatment in Pregnancy, IPTP,
drugs and they would be given free.’’
The actual problem, she said, is that some healthcare providers do not know how to read the
microscopic which is the ultimate in malaria testing so they just put++ and tell people that they have malaria while in actual sense they do not have malaria. ‘’We are also teaching the mocroscopics how to trust the RDTs because malaria cases are coming down in Nigeria
because a lot of them don’t want to agree maybe because the person still has the symptoms of fever. So it is important that you diagnose and treat properly, she
advised Nigerians.
“We also do seasonal malaria chemo prevention in the northern part for children under the age of five because the malaria season in this part of the country is about three to four months so within that period, we give children a particular medicine to cover them at that time. There is indoor residual spraying whereby you spray the walls of your homes
with the correct insecticide so you won’t have malaria.’’
In the last three years, government has distributed 51 million mosquito treated nets to Nigerians to replace old ones. From 2009 till now over 100 million nets has been given to Nigerians, Eziegwu told Nigerian Pilot.

Another milestone discovery in malaria elimination from the world is the recent world’s first malaria vaccine, which represents a major foothold towards prevention of the singular disease that kills more than half as million people globally, most of whom are
children in Africa.
Acording to experts, roughly 40 species of Anopheles mosquito which acts as hosts for
the types of malaria that affects humans are found all over the world. Five types of malaria
that cause illnesses in humans are the plasmodium falciparum, which is responsible for majority of malaria- related deaths which killed 528,000 people in sub-
Saharan Africa in 2013.